An mHealth model to increase clinic attendance for breast symptoms in rural Bangladesh: can bridging the digital divide help close the cancer divide?

Autor: Ginsburg OM; Women's College Research Institute, Faculty of Medicine and Dalla Lana Faculty of Public Health, University of Toronto, Toronto, Ontario, Canada; mPower Social Enterprises, Dhaka, Bangladesh; Amader Gram, Khulna, Bangladesh; International Breast Cancer Research Foundation, Madison, Wisconsin, USA., Chowdhury M, Wu W, Chowdhury MT, Pal BC, Hasan R, Khan ZH, Dutta D, Saeem AA, Al-Mansur R, Mahmud S, Woods JH, Story HH, Salim R
Jazyk: angličtina
Zdroj: The oncologist [Oncologist] 2014 Feb; Vol. 19 (2), pp. 177-85. Date of Electronic Publication: 2014 Jan 06.
DOI: 10.1634/theoncologist.2013-0314
Abstrakt: Objective: To demonstrate proof of concept for a smart phone-empowered community health worker (CHW) model of care for breast health promotion, clinical breast examination (CBE), and patient navigation in rural Bangladesh.
Methods: This study was a randomized controlled trial; July 1 to October 31, 2012, 30 CHWs conducted door-to-door interviews of women aged 25 and older in Khulna Division. Only women who disclosed a breast symptom were offered CBE. Arm A: smart phone with applications to guide interview, report data, show motivational video, and offer appointment for women with an abnormal CBE. Arm B: smart phone/applications identical to Arm A plus CHW had training in "patient navigation" to address potential barriers to seeking care. Arm C: control arm (no smart phone; same interview recorded on paper). Outcomes are presented as the "adherence" (to advice regarding a clinic appointment) for women with an abnormal CBE. This study was approved by Women's College Hospital Research Ethics Board (Toronto, Ontario, Canada) and district government officials (Khulna, Bangladesh). Funded by Grand Challenges Canada.
Results: In 4 months, 22,337 women were interviewed; <1% declined participation, and 556 women had an abnormal CBE. Control group CHWs completed fewer interviews, had inferior data quality, and identified significantly fewer women with abnormal breast exams compared with CHWs in arms A and B. Arm B had the highest adherence.
Conclusion: CHWs guided by our smart phone applications were more efficient and effective in breast health promotion compared with the control group. CHW "navigators" were most effective in encouraging women with an abnormal breast examination to adhere to advice regarding clinic attendance.
Databáze: MEDLINE
Externí odkaz: